October 15

Global
Handwashing
Day
ANNEX 6.
Essential
Handwashing
Facts
Handwashing and Health
General
y Hands are the principal carriers of disease-causing germs. It is estimated that if handwashing
with soap is widely practiced, approximately 230,000 deaths could be averted.
y A single gram of human feces can contain 10 million viruses and one million bacteria.
Handwashing and Diarrheal Disease
y Diarrheal disease is a critical global public health issue. Each year, there are nearly 1.7 billion cases
of diarrhea.
y Handwashing alone can reduce the risk of diarrheal disease by up to 44 percent.
y Evidence shows that hygiene is as important as water and sanitation in reducing diarrhea.
y Lack of access to sanitation and poor hygiene contributes to approximately 88% of childhood
deaths caused by diarrheal diseases.
y Handwashing with soap is easy, efcacious, and the most cost-efective WASH intervention for
reducing diarrhea, but it is often overlooked.
y Diarrhea is responsible for children missing 272 million school days each year. A recent study
suggests that handwashing with soap at critical times could help reduce school absenteeism
40-50 percent.

In an intervention in Kenya, children in schools that received a comprehensive
school-based WASH intervention, including hygiene promotion, had nearly a 50 percent
reduction in diarrheal illness.
y One study found that in patients with AIDS, handwashing with soap reduced the episodes of
diarrheal illnesses.
Handwashing and Pneumonia
y Pneumonia is the leading causes of death for children under the age of 5 resulting in 1.1 million
childhood deaths in 201217 percent of all deaths in the age group. Every day in 2012, pneumonia
killed more than 3,000 children under the age of ve.
y Handwashing with soap can reduce pneumonia infections by approximately 25 percent.
ANNEX 6.
Essential Handwashing Facts
ANNEX 6. Essential Handwashing Facts
Handwashing and Nutrition
y Evidence suggests that access to soap and water can help improve child growth. It is estimated
that handwashing with soap and clean drinking water could reduce the loss of nutrients through
diarrhea, and reduce stunting in children under the age of ve by up to 15 percent.
Handwashing and Newborns
y Three million neonatal deaths occur each year, and neonatal infections account for approximately
36 percent of these deaths. Evidence suggests that handwashing with soap can signicantly reduce
newborn deaths. For example, in one study, the mortality rate among neonates exposed to birth
attendants and mothers who had good handwashing practices was approximately 40% less than
neonates whose birth attendants and mothers had poor handwashing practices.
Handwashing and Other Outcomes
y Emerging evidence suggests that handwashing may also play a role in preventing soil-transmitted
helminth infections, which infect over 1.5 billion people.
y A study in Pakistan found that handwashing with soap reduced the number of cases of impetigo
skin infection by 34 percent.
y It is estimated that 41 million people, mostly women and children, have active trachoma
infection, the worlds leading infectious cause of blindness. Evidence shows that facewashing is
critical to preventing the spread of this blinding disease.

Facewashing is an important hygiene
intervention that can be combined with handwashing to enhance health outcomes through
hygiene interventions.
y A study in Pakistan found that handwashing promotion could improve child development
and well-being.
Access to Handwashing Stations
y There are inequities in hygiene access. Poorer households, those located in rural areas, and
those with less education have lower access to functional handwashing stations than wealthier
households, those in urban areas, and those with higher education.
y The absence of WASH facilities, including handwashing stations, in schools and workplace is
an equity issue for girls and women, particularly when they must manage their menstrual cycle.
ANNEX 6. Essential Handwashing Facts
Handwashing Behavior
Motivators
y Motivators for handwashing difer in every community. However, some common motivating factors
are to avoid disgust, good manners, desire for a social status associated with cleanliness, wanting to
t in with the handwashing behavior of peers and role models, wanting to nurture children, and the
comfort of having clean hands.
y A study in a Kenyan primary school found that more handwashing occurred when there
was another person at the handwashing station than when a student was at the handwashing
station alone.
Frequency of Handwashing Behavior
y Even though handwashing is a cornerstone of public health, actual rates of handwashing around
the world are quite low and vary widely. A 2009 systemic review found that on average
handwashing with soap was practiced 17 percent of the time.